Provider Demographics
NPI:1932487576
Name:RAY, RONALD (DDS)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:RAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43930 FARMWELL HUNT PLZ
Mailing Address - Street 2:SUITE 136
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5896
Mailing Address - Country:US
Mailing Address - Phone:703-858-0045
Mailing Address - Fax:700-385-8004
Practice Address - Street 1:43930 FARMWELL HUNT PLZ
Practice Address - Street 2:SUITE 136
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5896
Practice Address - Country:US
Practice Address - Phone:703-858-0045
Practice Address - Fax:700-385-8004
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010075751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice